Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life.
Aortic valve stenosis
Mood
Nutritional status
Older adults
Quality of life
Short physical performance battery
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
06
05
2021
accepted:
18
08
2021
pubmed:
28
8
2021
medline:
8
3
2022
entrez:
27
8
2021
Statut:
ppublish
Résumé
Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention. To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term. This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant's clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests. Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4. Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.
Sections du résumé
BACKGROUND
BACKGROUND
Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention.
AIMS
OBJECTIVE
To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term.
METHODS
METHODS
This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant's clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests.
RESULTS
RESULTS
Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4.
CONCLUSIONS
CONCLUSIONS
Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.
Identifiants
pubmed: 34448150
doi: 10.1007/s40520-021-01969-x
pii: 10.1007/s40520-021-01969-x
pmc: PMC8894170
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
643-652Informations de copyright
© 2021. The Author(s).
Références
Eur J Cardiothorac Surg. 2011 Jan;39(1):33-7
pubmed: 20627611
JAMA. 1963 Sep 21;185:914-9
pubmed: 14044222
JPEN J Parenter Enteral Nutr. 2013 Jan;37(1):37-43
pubmed: 22549764
J Gerontol A Biol Sci Med Sci. 2011 Jan;66(1):89-96
pubmed: 20861145
Eur Heart J. 2003 Jul;24(13):1231-43
pubmed: 12831818
J Am Coll Cardiol. 2010 Nov 9;56(20):1668-76
pubmed: 21050978
Qual Life Res. 2001;10(5):405-13; discussion 415-20
pubmed: 11763203
Clin Nutr ESPEN. 2018 Aug;26:84-90
pubmed: 29908689
J Gerontol A Biol Sci Med Sci. 2003 Aug;58(8):712-4
pubmed: 12902528
J Am Geriatr Soc. 2001 Sep;49(9):1142-7
pubmed: 11559371
J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):917-921
pubmed: 28329140
J Am Coll Cardiol. 2013 Sep 10;62(11):1002-12
pubmed: 23727214
J Physiol. 2015 Sep 15;593(18):4259-73
pubmed: 26173027
Int J Geriatr Psychiatry. 2017 Dec;32(12):e141-e149
pubmed: 28195361
J Am Geriatr Soc. 1968 May;16(5):622-6
pubmed: 5646906
Eur Heart J. 2017 Sep 21;38(36):2739-2791
pubmed: 28886619
BMJ. 1992 Jul 18;305(6846):160-4
pubmed: 1285753
Gerontologist. 1969 Autumn;9(3):179-86
pubmed: 5349366
Int J Surg. 2011;9(1):104-9
pubmed: 20965288
Curr Opin Clin Nutr Metab Care. 2012 Jan;15(1):29-41
pubmed: 22037014
Interact Cardiovasc Thorac Surg. 2013 Feb;16(2):116-22
pubmed: 23148084
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
Int J Cardiol. 2016 Jul 15;215:487-93
pubmed: 27131770
J Am Geriatr Soc. 2005 Apr;53(4):695-9
pubmed: 15817019
Ann Thorac Surg. 2015 Jan;99(1):55-61
pubmed: 25442986
J Psychiatr Res. 1982-1983;17(1):37-49
pubmed: 7183759
JAMA Cardiol. 2018 Mar 1;3(3):191-197
pubmed: 29344620
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Arch Gerontol Geriatr. 2015 Mar-Apr;60(2):252-8
pubmed: 25496605
Eur J Cardiothorac Surg. 2020 Aug 1;58(2):221-229
pubmed: 32236543
Circulation. 2018 Nov 13;138(20):2202-2211
pubmed: 29976568
Circulation. 2005 Jun 21;111(24):3316-26
pubmed: 15967862
J Chronic Dis. 1985;38(6):517-24
pubmed: 4008592
J Thorac Cardiovasc Surg. 2013 May;145(5):1173-89
pubmed: 23415689